One day is the right moment. It remains to find the right person. Psychoanalyst, psychotherapist, psychologist, psychotherapist.. which psychiatrist to choose? Who, what, how here is our guide to see more clearly.
How to find it?
Make sure of your qualifications
Draw the first name of the directory? Ring at the one who put his plate down the building opposite? Some therapies take place from happy chances. But we can also fall on someone whose training leaves something to be desired or whose approach is not adapted to our problematic. Let’s make sure we have the minimum: does he have the official title of psychotherapist? If he is a psycho-practitioner, is he certified? If he is a psychoanalyst, does he belong to a recognized school? Did he even do a therapy? Can he justify theoretical, methodological and practical training in a recognized method and training in clinical psychopathology? Is he in supervision, this indispensable external view which also acts of continuous training? Has he posted in his office the code of ethics of his profession? Does he belong to an association of psys?These are serious guarantees that professionals often specify on their website.
Another possibility is that a relative gives us a contact, often after having himself asked his psychiatrist.But be careful: no question of taking the same therapist! Because he will not be able to welcome us with the curiosity and the benevolent neutrality necessary for the therapeutic accompaniment and that, for our part, we risk being taken in conflicts of loyalty: how to tell him, for example, the jealousy how do we feel towards this friend, who is also his patient? Especially since even the best of psys may not be the right professional for us. Psychological injuries are not treated like angina or sprains, with prescriptions valid for all. There is also the feeling, the confidence that inspires us the practitioner: a look that carries us, a word that is a hit, the comforting feeling of finally being understood …
Evaluate the practicalities
It has long been thought that, to be effective, therapy must be costly in time and money. At present, psychologists recognize that an overly restrictive approach, which does not take into account the patient’s obligations, may stop quickly. One must be sure, for example, that after an exhausting day, we will still be motivated enough to propel us to the office. It is therefore better to choose a professional near our home or our work, or opt for remote therapy (by Skype, phone, WhatsApp …). And to make sure that the fare can be adjusted to our possibilities.
Trust your instinct
Another question: should I choose a woman or a man? If, theoretically, each of them can accommodate all the problems, we can legitimately feel more comfortable with one or the other, depending on the subject that teases us. The cabinet also counts: contemporary design or deco baba, the whole thing is to find it well. Because therapy is an encounter. We must immediately feel welcomed, taken seriously. If we are bored, are uncomfortable, if we do not go out a little moved and lightened, soothed, we probably did not hit the right door. Good news: there are many others. And behind one of them, “our” psychiatrist is waiting for us.
Which method for me?
There are several hundred psychotherapeutic methods . What creativity, what dynamism … and what a mess! To find you there, the point on the five current great currents.
I want to discover my unconscious: I choose psychoanalysis
Whether Freudian, Jungian, Lacanian …, the psychoanalyst helps us to look into the mysteries of our unconscious. His role – in the transgenerational, family, child, couple, work fields … – is to listen to us, to help us to carry out the investigation of ourselves to discover what is behind our suffering, which prevents us from advancing into existence, or makes us repeat the same scenarios. The founding idea of the father of psychoanalysis, Sigmund Freud, is indeed that our infantile sexual fantasies and the forgotten events of our childhood shape our unconscious, creating our neuroses and our symptoms of adults. In session, we are invited to say what goes through our head without censoring us, because these free associations are not due to chance. Dreams, for example, are considered by Freud as “the royal way of knowing the unconscious”. Slips, missed acts and symptoms are seen as the expression of a repressed desire or unresolved psychic conflict. Through the transfer that the patient makes on his shrink, he can bring out his childhood experience, his fantasies, impulses and motives unacknowledged.In its traditional version, the cure takes place on a couch, lying down, the psychoanalyst being behind his “analysand”, out of his eyes. Its duration is rather long, ranging from a few years to a lifetime, with several sessions a week or less. It can also be done in analytical psychotherapy of two to five years, that is to say, face to face, with a weekly session.
I want to be fully considered: I choose a humanistic therapy
Born in the United States in the 1950s, this therapeutic trend intended to stand out from psychoanalysis and behavioral therapies, and “put man back at the center of psychology”: to see him as a responsible subject, free of his choices and his growth. It includes approaches as diverse as gestalt , bioenergetic analysis, psychodrama, transactional analysis , person-centered approach, psycho-organic analysis, hypnotherapy , psychosynthesis, neurolinguistic programming (NLP) ) , the transpersonal … Their common point is to consider the individual in its five dimensions (physical, emotional, cognitive, social and spiritual), to pay attention to the body (sensations, breathing, postures …) and emotions. They value our right to be different, to develop our own values and to make unique choices. Influenced by existentialist philosophy, some also take into account the important issues that agitate us (freedom, responsibility, the quest for meaning, finiteness, imperfection). They often last between one and three years, take place face-to-face, in individual or couple weekly sessions, and are often accompanied by group sessions.
I want to quickly solve a specific problem: I choose CBT
Initially behavioral in the 1950s, these therapies were enriched by cognitive approaches ( behavioral and cognitive therapies or CBT ), then emotional, to the point of now taking the name TECC (emotional, behavioral and cognitive therapies). They are based on the theories of learning, with the idea that our sufferings (phobias, post-traumatic stress syndrome, addictions, OCD …) come from poor conditioning. It is then a matter of deconstructing them and replacing them with new, less painful learning. By opening, with the shrink, to other possible interpretations: when the spider moves, is it to escape or to attack you?Does alcohol really make you more comfortable in society? By rationalizing: are there more deaths on the plane than on the roads in France? By learning mindfulness meditation and relaxation to counter anxiety, then to combine the dreaded stimulus with a relaxing body response. A TECC also proposes to do exercises and role plays to gradually be exposed to the difficult situation, and realize that the association with the anxiety state is extinguished. CBT are short therapies (between ten and fifteen sessions) that are practiced individually, but also in groups (four to eight sessions).
I have a family problem: I choose systemic therapy
The systemic approach, born in the United States in the 1950s, developed in Europe in the 1970s. Its originality? Consider the disorder of an individual in the context of the context in which it occurs. The human being always fits in an environment and forms with him a particular “system”: the symptom of one is not an independent dysfunction, but the result of a relational dysfunction. That’s why he can not be treated without analyzing how family members interact, without understanding how the “system” works. Systemic therapy is particularly indicated in case of relationship difficulties and conflicts in the couple or the family. It also helps to better understand behavioral problems in a child or teenager (anorexia, school phobia, drug addiction). It is with the family that one consults, generally once a month, between an hour and an hour and a half. To better understand the interactions of the group, the therapists can be two: the first leads the interview and the second observes. Therapy, pragmatic and focused on the present, is often brief (about ten sessions).
I am curious about the different tools: I choose the integrative
Appeared in the 1980s, integrative psychotherapy is a multi-referential approach that “integrates” several currents and therapeutic tools, assuming that they are complementary. The idea? Move away from the shackles of an ideology to use the right method at the right time. Depending on the difficulty encountered by the patient and the relationship he has with his therapist, it will draw on the concepts and practices specific to gestalt, transactional analysis, psycho-corporal therapy or psychoanalysis. To some, he will propose a work predominantly analytical. To others, a technique focused on emotions.Stress, depressive state, marital problems, relational or existential difficulties are reasons for entering therapy. It lasts from six months to two years on average. The sessions take place every week or fortnight.
Who does what ?
He is a doctor, specialized in psychiatry. He can therefore prescribe medical examinations to, for example, discriminate a thyroid disorder from a bipolar disorder. He is the only psychotherapy professional with the ability to diagnose mental illness and prescribe medication. His psychiatry consultations are (partly) reimbursed by Social Security. Some agree to issue care sheets for counseling in psychotherapy, but not all are trained in addition to their medical studies. Some psychiatrists have also not done work on them and are not supervised, two essential commitments to accompany patients in psychotherapy.
He is a practitioner of psychoanalysis. Its title is not protected but, to be recognized, it must belong to an association or a psychoanalytic society (School of the Freudian cause, Psychoanalytic Society of Paris …) which ensures its formation and frames its practice. With three ethical requirements: to have an advanced personal analysis, to have a theoretical training, to be supervised by an experienced psychoanalyst.
The clinical psychologist
Trained at the university or at the School of Practicing Psychologists (EPP, called “Psychoprat”), he received theoretical and clinical training (several hundred hours of internship in an institution). He can possibly have completed his baggage by learning a specific method (CBT, family system, gestalt …). If he was encouraged in his course to do a personal therapy and to be supervised, he is unfortunately not obliged by his code of ethics. Clinical psychologists are qualified to pass assessment, orientation or psychopathological tests, which are then validated by a psychiatrist. In institutions (hospitals, medico-psychological centers, etc.), consultations are handled by Social Security. In some pilot cities, it also reimburses some sessions for young people.
This is the official title 1 , which is reserved for professionals registered in the National Register of Psychotherapists. This title provides minimal training, but does not qualify what is happening in therapy.It is granted to professionals with very different curricula and practices: psychiatrist, clinical psychologist, other doctors (provided that they have complementary training), but also some psychoanalysts and psychotherapists.
This is the term used by those who practice psychotherapy without having the official title of psychotherapist. He was trained in a private school, one or more specific postures: psycho-organic analysis, psychosynthesis … The title is not protected, everyone can say psycho-therapist. We will therefore rely on those who are affiliated with major federations and associations of psys, asking their members very high criteria: French Federation of Psychotherapy and Psychoanalysis (FF2P), National Union of Practitioners in Relational Psychotherapy and Psychoanalysis (SNPPsy), Association French federation of relational psychotherapy and psychoanalysis (Affop) …
1. Framed by the State since the law on public health of 9 August 2004, amended by two decrees, in 2010 and 2012.
What a shrink will never do for us?
He can not under any circumstances force us to get better despite ourselves. He is there to help us untie our conflicts, heal the wounds caused by the traumatic events of our lives, to boost our desire to move forward. But as long as we do not understand that we are entitled, like everyone else, to a satisfactory existence, the work stagnates. Then, he will never give us the status of a victim to complain that we often claim at the beginning of therapy: it will rather make us understand how this position is unproductive. Finally, it will not provide us with ready-made recipes to transform us: the solutions we will invent together.